Eureka Family Dental P.C.
Organization Active NPI Dentist · Eureka, IL
NPI 1396282240 · NPPES record last updated Jan 30, 2017
Key facts
- NPI
- 1396282240
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 019023704 (IL)
- Legal business name
- EUREKA FAMILY DENTAL P.C.
- Practice address
- 2000 S Main St
Eureka, IL 61530-1663 - Phone
- (309) 467-3515
- NPI assigned
- Jan 30, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Michael Moon, DDS
- Title
- Co-Owner
- Phone
- (309) 467-3515
Practitioners 1
National Provider Directory
Locations
2000 S Main St
Eureka, IL 61530
Phone (309) 467-3515
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 019023704 | IL | Yes |
| Dentist |
122300000X | 019028324 | IL |
Addresses
Primary practice location
2000 S Main St
Eureka, IL 61530-1663
Mailing address
2000 S Main St
Eureka, IL 61530-1663
Phone (309) 467-3515
Other providers in Eureka, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.